A 47-Year-Old Female with Shortness of Breath

This patient is a 47-year-old female with a history of end-stage liver disease secondary to hepatitis C virus (HCV) complicated by hepatic encephalopathy, obstructive sleep apnea, asthma, and severe peripheral neuropathy who presents to the hospital with complaints of shortness of breath and cough. The patient was recently discharged from an outside hospital 2 days prior to this admission where she was treated for pneumonia and an asthma exacerbation but her symptoms have not improved. She complains of shortness of breath at rest and severely decreased exercise tolerance with dyspnea while walking across the room. Her cough is persistent and non-productive. Review of systems is also positive for fevers at the outside hospital and worsening peripheral neuropathy which has not responded to treatment with gabapentin. Social history is positive for 20 pack-year smoking history (quit 10 years ago), and heavy alcohol use in the past

Exploring behavioural responses of shorebirds to impulsive noise

Despite recent research interest in the consequences of chronic noise for animal populations, the effects of impulsive noise are less well understood. Determining wildlife responses to impulsive sound is pertinent in coastal areas where development of port and power generation industries may result in disturbance from impulsive sounds such as percussive piling, especially around estuaries which may support internationally important numbers of bird species. Discussions between regulators, planning authorities and regional development agencies over precautionary levels of impulsive sound emitting activities are common, yet we're unaware of any study which provides guidance on acceptable noise limits that would keep disturbance to shorebirds to a minimum. This experimental study intentionally disturbed birds at a high tide roost site, an agricultural field adjacent to the sea wall on the south bank of the Humber estuary in northern England, using an impulsive sound, and their behavioural responses were recorded. The researcher sounded an air-horn at ever decreasing distances towards a mixed species flock of shorebirds. While visual disturbance from the experimenter was taken into consideration in the mediods, we cannot statistically separate their effects in this study. An ordinal logistic regression model demonstrated a statistically significant positive relationship between the decibel (dB(A)) level experienced by the birds and the behavioural response observed. In principle, this model can be used to predict the probability of a particular behavioural response at a given dB(A) level. Estimates of sound levels which included calculation of geometric and atmospheric attenuation were superior over more simple measures in predicting behavioural responses. This study has implications for assessing possible disturbance caused by impulsive noise, and adds to growing evidence that the effects of noise may be an important, albeit not straightforward, consideration in management decisions made for shorebirds and other avian species. ©Wildfowl & Wedands Trust

A panel model for predicting the diversity of internal temperatures from English dwellings

Using panel methods, a model for predicting daily mean internal temperature demand across a heterogeneous domestic building stock is developed. The model offers an important link that connects building stock models to human behaviour. It represents the first time a panel model has been used to estimate the dynamics of internal temperature demand from the natural daily fluctuations of external temperature combined with important behavioural, socio-demographic and building efficiency variables. The model is able to predict internal temperatures across a heterogeneous building stock to within ~0.71°C at 95% confidence and explain 45% of the variance of internal temperature between dwellings. The model confirms hypothesis from sociology and psychology that habitual behaviours are important drivers of home energy consumption. In addition, the model offers the possibility to quantify take-back (direct rebound effect) owing to increased internal temperatures from the installation of energy efficiency measures. The presence of thermostats or thermostatic radiator valves (TRV) are shown to reduce average internal temperatures, however, the use of an automatic timer is statistically insignificant. The number of occupants, household income and occupant age are all important factors that explain a proportion of internal temperature demand. Households with children or retired occupants are shown to have higher average internal temperatures than households who do not. As expected, building typology, building age, roof insulation thickness, wall U-value and the proportion of double glazing all have positive and statistically significant effects on daily mean internal temperature. In summary, the model can be used as a tool to predict internal temperatures or for making statistical inferences. However, its primary contribution offers the ability to calibrate existing building stock models to account for behaviour and socio-demographic effects making it possible to back-out more accurate predictions of domestic energy demand

OncoLog Volume 47, Number 02, February 2002

Molecular Therapies Target Bone Metastasis I\u27m Here to Help You Patient Advocates Serve as Liaisons Between Patients and Care Centers DiaLog: Patient Advocates: Solving Problems and Building Bridges, by Charles F. Leverback, MD, Associate Professor, Department of Gynecologic Oncology House Call: Keeping the Heart Healthy in Patients with Cancerhttps://openworks.mdanderson.org/oncolog/1103/thumbnail.jp

OncoLog Volume 46, Number 09, September 2001

Completing the Job: Multidisciplinary Effort Restores Form and Function, Improves Patients\u27 Quality of Life House Call: Denial and Cancer Protocols: Studies Examine Treatments for Glioma DiaLog: Addressing the Problem of Patients\u27 Denial, by Renato Lenzi, MD, Associate Professor, Department of Gastrointestinal Medical Oncology New Replication-Competent Adenovirus Shows Promise against Gliomas in Preclinical Studieshttps://openworks.mdanderson.org/oncolog/1099/thumbnail.jp

OncoLog Volume 47, Number 05, May 2002

Tobacco Research and Treatment Progra Studies Include Ways to Prevent and Treat Nicotine Dependence in Special Populations Emergency Center Provides Specialized Care for M. D. Anderson Patients Experiencing Oncologic Emergencies DiaLog: M. D. Anderson\u27s Emergency Center, by Carmelita Escalante, MD, Associate Professor and Ad Interim Chair, Department of General Internal Medicine, Ambulatory Treatment, and Emergency Care House Call: Depression and Cancer Smoking Cessation Studies Blend Computer Technology with Behavioral Therapyhttps://openworks.mdanderson.org/oncolog/1106/thumbnail.jp

OncoLog Volume 45, Number 01, January 2000

Pediatric Brain Tumor Studies Focus on Reducing Side Effects, Locating Biological Targets Retinoid Chemoprevention Trial Aims to Reverse Genetic Changes Caused by Smoking DiaLog: Surviving Cancer and Staying Healthy, by Rena Sellin, MD, Professor, Department of Internal Medicine Specialties House Call: From Biopsy to Diagnosis: Understanding the Process Protocols: Pediatric Brain Tumor Clinical Trials Protocols: Chemoprevention Studies Feature a Variety of Agentshttps://openworks.mdanderson.org/oncolog/1081/thumbnail.jp

Embryonal Rhabdomyosarcoma in the Pelvis of a 22-Year-Old Female: A Case Report

Embryonal rhabdomyosarcoma is a rare soft-tissue sarcoma that is responsible for less than 1% of malignancies in the adult population. We present a case of a 22-year-old female with a six-month history of abnormal uterine bleeding that was found to have an exophytic mass within the cervix. Magnetic resonance imaging was performed and revealed a large pelvic mass. Further workup included biopsies and surgical removal of the tumor, leading to the diagnosis of embryonal rhabdomyosarcoma. PET scan showed no FDG-avid malignancy, aiding in the decision-making process for adjuvant treatment to include vincristine, actinomycin D, cyclophosphamide, and mesna. This case is important to document due to the rarity of this disease and to serve as a reminder to gynecologists to consider the addition of rhabdomyosarcoma in the differential diagnosis when evaluating young adult females presenting with abnormal uterine bleeding and a cervical mass lesion

OncoLog Volume 45, Number 06, June 2000

Newly Organized Ophthalmology Section Expands Treatment of Ocular Malignancies Turning Knowledge Into Effective Gene Therapies, by Jack A. Roth, MD, Professor, Department of Thoracic and Cardiovascular Surgery, and Gary S. Clayman, MD, DDS, Associate Professor, Head and Neck Surgery Microarrays Reduce Time, Labor, and Cost of DNA Analysis New DNA Microarray Technology Could Speed Up Discovery of the Genetic Causes of Lung Cancer House Call: Virtual Health: Finding Reliable Medical Resources on the Internet Clinical Practice Guidelines: Case Report: Ovarian Cancer Protocols: Studies Aim to Detect and Treat Ocular Malignancieshttps://openworks.mdanderson.org/oncolog/1086/thumbnail.jp

OncoLog Volume 45, Number 09, September 2000

Multidisciplinary Care Improves Treatment, Enhances Quality of Life for Patients with Colorectal Cancer DiaLog: Treating Cancer with a Team Approach, by David L. Callender, MD, Senior Vice President and Chief Medical Officer Cervical Cancer Prevention: Could Spectroscopy Steal the Spot light ? Virtual Colonoscopy a Potential Screening Reality Protocols: Clinical Trials for Colorectal Cancer Compass: Clinical Practice Guidelines House Call: Sharing Personal Stories: Books Written by People with Cancerhttps://openworks.mdanderson.org/oncolog/1088/thumbnail.jp